Health Care Law Blog
In 2008, the Michigan Supreme Court concluded that domestic partnership policies intended to provide health care benefits to same sex couples violated Michigan law. Specifically, National Pride at Work v Governor held that such policies violated the Michigan Marriage Amendment (“Marriage Amendment”) by recognizing same sex domestic partnerships as analogous to a marriage or similar union. (The Marriage Amendment recognizes the union of one man and one woman as the only agreement recognized as a marriage and also prohibits public employers from providing health insurance benefits to their employees' same-sex domestic partners.)
The Office for Civil Rights of the Department of Health and Human Services recently released its final rule (the "Rule") modifying the Health Insurance Portability and Accountability Act ("HIPAA") and implementing the statutory requirements of the Health Information Technology for Economic and Clinical Health Act (“HITECH”). (The Rule was originally expected to be released in February of 2010 when HITECH became effective.) In short, the Rule: modifies HIPAA’s privacy, security and enforcement rules; changes HIPAA’s enforcement rules to increase penalties consistent with HITECH; provides a final rule on breach notification; and modifies HIPAA as required by the Genetic Information Nondiscrimination Act.
The new rule is approximately 563 pages and can be accessed here. If you have any questions about how the Rule may impact your health care practice, please contact Nicole Stratton at (517) 371-8140 or by using the form below.
The Michigan Board of Dentistry has adopted several new rules governing the handling and disposal of amalgam waste for dentists and dental practices.
There are some exceptions for oral and maxillofacial surgeons; oral and maxillofacial radiologists; oral pathologists; orthodontists; periodontists; and dentists providing services in a dental school or hospital, or through a local health department.
Employers with 50 or more full time equivalent employees (“FTEs”) will be subject to a penalty tax for: (1) failing to offer health care coverage to all full time employees; ( 2) offering minimum essential coverage that is unaffordable; or (3) offering minimum essential coverage where the Plan pays less than 60% of cost. This is often referred to as the Employer Mandate of PPACA.
The Patient Protection and Affordable Care Act ("PPACA") requires "large employers" to provide affordable health coverage of a minimum value to full-time employees and their dependents starting in 2014. A large employer failing to do so may be subject to penalties.
Coverage is considered affordable to an employee if the employee portion of the self-only premium for the employer's lowest-cost coverage does not exceed 9.5% of the employee's household income, but only if the lowest-cost coverage provides a minimum value.
Hospitals are required to report certain adverse clinical privileging actions and medical malpractice payments to the National Practitioner Data Bank (NPDB). Since the NPDB was established by the Health Care Quality Improvement Act (HCQIA) in 1986, compliance with these reporting obligations has been largely entrusted to hospitals with little enforcement action by the United States Department of Health and Human Services. There are now reports that the federal government has begun auditing compliance by hospitals with the NPDB reporting requirements.
Changes to the health insurance market in Michigan may soon be changing due to the Michigan House of Representatives’ approval of Senate Bills 1293 and 1294 (the “Senate Bills”) on December 6, 2012. The introduction of the Senate Bills follow Governor Snyder’s proposed overhaul of BCBSM discussed here and directly address the corporate organization and continued operation of Blue Cross Blue Shield of Michigan (“BCBSM”) in our state. In brief, the Senate Bills authorize BCBSM to establish, own, operate and merge with a nonprofit mutual disability insurer. They also generally prohibit BCBSM from using “Most Favored Nation Clauses” in provider contracts beginning February 1, 2013. While the Senate Bills are not final until Governor Snyder signs them into law, given his previous support it is likely he will give his approval. A more detailed analysis of the Senate Bills will be provided if the Governor does indeed sign them into law.
Over the past several weeks, the nation has seen a flurry of announcements issued by states as to how such states will implement and operate the health insurance exchanges (“HIE”) required by the Affordable Care Act. States have three options as to how they may run their HIEs:
On Monday, November 26, 2012 the Department of Health and Human Services ("DHHS") issued proposed rules on: (1) standards related to essential health benefits, actuarial value and accreditation, and (2) health insurance market rules and rate review. The Department of Treasury, the Department of Labor, and DHHS issued combined proposed rules for the incentives of wellness programs. Comments on these proposals must be received no later than December 26, 2012. So those interested in commenting have a short window to examine the three sets of rules. For more on these topics and how they will impact you, stay tuned to the Foster Swift Health Care Blog.
As we previously reported, the Department of Health & Human Services (“DHHS”) extended some important deadlines for states establishing State-Based Insurance Exchanges or State Partnership Exchanges for 2014. Specifically, DHHS extended the submission deadline for State-Based Exchange Blueprints to December 14, 2012. However, the administration previously still required states to submit Declaration Letters of their intent to build state-based Health Insurance Exchanges by November 16th. However, as of Thursday (November 15th), only 17 states and the District of Columbia had committed to building their own Exchanges. This is far fewer than envisioned by the Obama administration when the law was passed in 2010. To give states more time, the Obama administration extended the deadline for the Declaration letters until December 14th. Thus, both Blue Prints of the specifics of the Exchange and Declaration Letters of states wishing to run their own Exchange are due on December 14th.
